Abstract
It is obvious that at least some of the toxic compounds responsible for uremia are metabolic products of protein catabolism. There is also ample evidence that protein metabolism is significantly altered in children with chronic renal insufficiency (Delaporte et al., 1976, 1978; Conley et al., 1980; Holliday et al., 1970; Grupe, 1981b). These studies, coupled with the empiric demonstration that low-protein diets alleviate many of the symptoms of uremia, have led to a precept that has now become axiomatic: stipulating low-protein intake in chronic renal insufficiency. There is, however, the rational goal of reducing the main dietary sources of hydrogen ion, phosphate, potassium, and sulfate to the lowest possible level commensurate with the patient’s renal function.
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References
Abitbol, C. L., and Holliday, M. A., 1976, Total parenteral nutrition in anuric children, Clin. Nephrol 5:153–158.
Abitbol, C. L., and Holliday, M. A., 1978, Effect of energy and nitrogen intake upon urea production in children with uremia and undernutrition, Clin. Nephrol. 10:9–15.
Alvestrand, A., Bergström, J., Fürst, P., Germais, G., and Widstam, U., 1978, Effect of essential amino acid supplementation on muscle and plasma free amino acids in chronic uremia, Kidney Int. 14:323–329.
Arnold, W. C., and Holliday, M. A., 1980, In vitro suppression of insulin-mediated amino acid uptake in uremic skeletal muscle, Am. J. Clin. Nutr. 33:1428–1432.
Betts, P. R., and Magrath, G., 1974, Growth pattern and dietary intake of children with chronic renal insufficiency, Br. Med. J. 2:189–193.
Betts, P. R., Magrath, G., and White, R. H. R., 1977, Role of dietary energy supplementation in growth of children with chronic renal insufficiency, Br. Med. J. 1:416–418.
Broyer, M., 1974, Chronic renal failure, in: Pediatric Nephrology (P. Royer, R. Habib, H. Mathieu, M. Broyer, and A. Walsh, eds.), pp. 358–394, Saunders, Philadelphia.
Broyer, M., Jean, G., Dartois, A., and Kleinknecht, C., 1980, Plasma and muscle free amino acids in children at the early stages of renal failure, Am. J. Clin. Nutr. 33:1396–1401.
Calloway, D. H., 1975, Nitrogen balance of men with marginal intakes of protein and energy, J. Nutr. 105:914–923.
Chantier, C., ElBishti, M., and Counahan, R., 1980, Nutritional therapy in children with chronic renal failure, Am. J. Clin. Nutr. 33:1682–1689.
Conley, S. B., Rose, G. M., Robson, A. M., and Bier, D. M., 1980, Effects of dietary intake and hemodialysis on protein turnover in uremic children, Kidney Int. 17:837–846.
Counahan, R., ElBishti, M., Cox, B. D., Ogg, C. S., and Chantier, C., 1976, Plasma amino acids in children and adolescents on hemodialysis, Kidney Int. 10:471–477.
Counahan, R., ElBishti, M., and Chantier, C., 1978, Oral essential amino acids in children on regular hemodialysis, Clin. Nephrol. 9:11–14.
Delaporte, C., Bergstrom, J., and Broyer, M., 1976, Variations in muscle cell protein of severely uremic children, Kidney Int. 10:239–245.
Delaporte, C., Geneviève, J., and Broyer, M., 1978, Free plasma and muscle amino acids in uremic children, Am. J. Clin. Nutr. 31:1647–1651.
Elwyn, D. H., Gump, F. E., Munro, H. N., Iles, M., and Kinney, J. M., 1979, Changes in nitrogen balance of depleted patients with increasing infusions of glucose, Am. J. Clin. Nutr. 32:1597–1611.
Flückiger, R., Harmon, W., Meier, W., Loo, S., and Gabbay, K. H., 1981, Hemoglobin carbamylation in uremia, N. Engl. J. Med. 304:823–827.
Garber, A. J., 1978, Skeletal muscle protein and amino acid metabolism in experimental uremia in the rat. Accelerated alanine and glutamine formation and release, J. Clin. Invest. 62:623–632.
Garza, C., Scrimshaw, N. S., and Young, V. R., 1976, Human protein requirements: The effect of variations in energy intake within the maintenance range, Am. J. Clin. Nutr. 29:280–287.
Garza, C., Scrimshaw, N. S., and Young, V. R., 1977, Human protein requirements: Evaluation of the 1973 FAO/WHO safe level of protein intake for young men at high energy intakes, Br. J. Nutr. 37:403–420.
Giordano, C., 1980, Amino acids and ketoacids—advantages and pitfalls, Am. J. Clin. Nutr. 33:1649–1653.
Giordano, C., DePascale, C., DeSanto, N. G., Esposito, R., Cirillo, D., and Standherlin, P., 1970, Disorder in the metabolism of some amino acids in uremia, in: Proceedings of the IVth International Congress of Nephrology, pp. 296–302, Karger, Basel.
Giordano, C., DeSanto, N. G., DiToro, R., Pluvio, M., and Perrone, L., 1978, The imbalance effect of amino acid and keto acid diet for growth of the uremic infant, in: Proceedings of the VIIth International Congress of Nephrology, pp. 477–482, Karger, Basel.
Grupe, W. E., 1981a, Nutritional considerations in the prognosis and treatment of children with renal disease, in: Textbook of Pediatric Nutrition (R. A. Suskind, ed.), pp. 527–536, Raven Press, New York.
Grupe, W. E., 1981b, Perinatal nutrition related to renal function, in: Gastroenterology and Nutrition in Infancy (E. Lebenthal, ed.), pp. 837–852, Raven Press, New York.
Harmon, W. E., Spinozzi, N. S., Sargent, J. R., and Grupe, W. E., 1979, Determination of protein catabolic rate (PCR) in children on hemodialysis by urea kinetic modeling, Pediatr. Res. 13:513.
Harmon, W. E., Spinozzi, N. S., Meyer, A., and Grupe, W. E., 1981, The use of protein catabolic rate to monitor pediatric hemodialysis, Dial. Transpl. 10:324–330.
Hegsted, D. M., 1978, Assessment of nitrogen requirements, Am. J. Clin. Nutr. 31:1669–1677.
Holliday, M. A., and Chantier, C., 1978, Metabolic and nutritional factors in children with renal insufficiency, Kidney Int. 14:306–312.
Holliday, M. A., Chantier, C., MacDonnell, R., and Keitges, J., 1977, Effect of uremia on nutritionally induced variations in protein metabolism, Kidney Int. 11:236–245.
Holliday, M. A., Wassner, S., and Ramirez, J., 1978, Intravenous nutrition in uremic children with protein-energy malnutrition, Am. J. Clin. Nutr. 31:1854–1860.
Inoue, G., Fugita, Y., Kishi, K., Yamamoto, S., and Niiyama, Y., 1974. Nutritive value of egg protein and wheat gluten in young men, Nutr. Rep. Intern. 10:201–207.
Jones, R. W. A., Dalton, N., Start, K., ElBishti, M. M., and Chantier, C., 1980, Oral essential amino acid supplements in children with advanced chronic renal failure, Am. J. Clin. Nutr. 33:1696–1702.
Keys, A. J., Andersen, J. T., and Brozek, J., 1955, Weight gain from simple overeating. I. Character of tissue gained, Metabolism 4:427–432.
Kopple, J. D., 1978, Abnormal amino acid and protein metabolism in uremia, Kidney Int. 14:340–348
Motil, K. J., Harmon, W. E., and Grupe, W. E., 1980, Complications of essential amino acid hyperalimentation in children with acute renal failure, J. Parent. Enteral. Nutr. 4:32–35.
Munro, H. N., 1964, General aspects of the regulation of protein metabolism by diet and by hormones, in: Mammalian Protein Metabolism (H. N. Munro and J. B. Allison, eds.), pp. 381–481, Academic Press, New York.
Munro, H. N., 1978, Energy and protein intakes as determinants of nitrogen balance, Kidney Int. 14:313–316.
Olson, R. E., 1975, The effect of variations in protein and calorie intake upon rate of recovery and selected physiologic response in Thai children with PCM, in: Protein—Calorie Malnutrition (R. E. Olson, ed.), p. 275, Academic Press, New York.
Sargent, J., Gotch, F., Borah, M., Piercy, L., Spinozzi, N., Schoenfeld, P., and Humphreys, M., 1978, Urea kinetics: A guide to nutritional management of renal failure, Am. J. Clin. Nutr. 31:1696–1702.
Spinozzi, N. S., and Grupe, W. E., 1977, Nutritional implications of renal disease, J. Am. Diet. Assoc. 70:493–497.
Spinozzi, N. S., Murray, C. L., and Grupe, W. E., 1978, Altered taste acuity in children with end-stage renal disease (ESRD), Pediatr. Res. 12:442.
Young, G. A., and Parsons, F. M., 1973, Impairment of phenylalanine hydroxylation in chronic renal insufficiency, Clin. Sci. Mol. Med. 45:89–97.
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© 1985 Plenum Publishing Corporation
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Grupe, W.E., Spinozzi, N.S., Harmon, W.E. (1985). Protein Utilization in Chronic Renal Insufficiency in Children. In: Cummings, N.B., Klahr, S. (eds) Chronic Renal Disease. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-4826-9_31
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DOI: https://doi.org/10.1007/978-1-4684-4826-9_31
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